| NPI | 1174933030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 306315) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AT5828009-955) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2022-07-21 |